Validation of the Machine Learning-Based Stroke Impact Scale With a Cross-Cultural Sample.

IMPORTANCE: The machine learning-based Stroke Impact Scale (ML-SIS) is an efficient short-form measure that uses 28 items to provide domain scores comparable to those of the original 59-item Stroke Impact Scale-Third Edition (SIS 3.0). However, its utility is largely unknown because it has not been cross-validated with an independent sample. OBJECTIVE: To examine the ML-SIS's comparability and test-retest reliability with that of the original SIS 3.0 in an independent sample of people with stroke. DESIGN: Comparability was examined with the coefficient of determination (R2), mean absolute error, and root-mean-square error (RMSE). Test-retest reliability was examined using the intraclass correlation coefficient (ICC). SETTING: Five hospitals in Taiwan. PARTICIPANTS: Data of 263 persons with stroke were extracted from a previous study; 144 completed repeated assessments after a 2-wk interval. RESULTS: High R2 (.87-.95) and low mean absolute error or RMSE (about 2.4 and 3.3) of the domain scores, except for the Emotion scores (R2 = .08), supported the comparability of the two measures. Similar ICC values (.39-.87 vs. .46-.87) were found between the two measures, suggesting that the ML-SIS is as reliable as the SIS 3.0. CONCLUSIONS AND RELEVANCE: The ML-SIS provides scores mostly identical to those of the original measure, with similar test-retest reliability, except for the Emotion domain. Thus, it is a promising alternative that can be used to lessen the burden of routine assessments and provide scores comparable to those of the original SIS 3.0. Plain-Language Summary: The machine learning-based Stroke Impact Scale (ML-SIS) is as reliable as the original Stroke Impact Scale-Third Edition, except for the Emotion domain. Thus, the ML-SIS can be used to improve the efficiency of clinical assessments and also relieve the burden on people with stroke who are completing the assessments.

Test-Retest Reliability and Responsiveness of the Computerized Adaptive Testing System of the Functional Assessment of Stroke.

OBJECTIVE: To examine the test-retest reliability, responsiveness, and clinical utility of the Computerized Adaptive Testing System of the Functional Assessment of Stroke (CAT-FAS) in persons with stroke. DESIGN: Repeated measurements design. SETTING: A department of rehabilitation in a medical center. PARTICIPANTS: 30 persons with chronic stroke (for test-retest reliability) and 65 persons with subacute stroke (for responsiveness) were recruited. To examine the test-retest reliability, the participants received measurements twice at 1-month intervals. To examine the responsiveness, the data were collected at admission and discharge from hospital. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUREMENT TOOL: CAT-FAS. RESULTS: The intra-class correlation coefficients of the CAT-FAS were ≥0.82, indicating good to excellent test-retest reliability. The Kazis' effect size and standardized response mean of the CAT-FAS were ≥0.96, indicating good group-level responsiveness. For individual-level responsiveness, approximately two-thirds of the participants exceeded the conditional minimal detectable change. On average, the CAT-FAS was completed within 9 items and 3 minutes per administration. CONCLUSIONS: Our results suggest the CAT-FAS is an efficient measurement tool with good to excellent test-retest reliability and responsiveness. In addition, the CAT-FAS can be used routinely in clinical settings to monitor progress of the crucial 4 domains for persons with stroke.

Translation and Validation of the Gaming Disorder Test and Gaming Disorder Scale for Adolescents into Chinese for Taiwanese Young Adults.

PURPOSE: To translate and cross-culturally adapt the Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A) for use in Taiwan and to validate their internal consistency, construct validity, measurement invariance, and convergent validity in Taiwanese young adults. METHODS: The GDT and GADIS-A were translated into traditional (unsimplified) Chinese characters and culturally adapted according to standard guidelines. A sample of 608 Taiwanese university students were recruited online. All participants completed the GDT, GADIS-A, Internet Gaming Disorder Scale - Short Form (IGDS9-SF), and Depression Anxiety Stress Scale-21 (DASS-21). Internal consistency was assessed using Cronbach's α and McDonald's ω. Factor structure was examined using Confirmatory Factor Analysis (CFA). Measurement invariance in gender was assessed by three nested models in CFA. Convergent validity was determined by calculating Pearson's r among the GDT, GADIS-A, IGDS9-SF, and DASS-21. RESULTS: The GDT and GADIS-A showed adequate internal consistency (both α and ω = 0.90). The CFA results supported a one-factor structure for the GDT and a two-factor structure for the GADIS-A. Measurement invariance across gender was supported for both the GDT and GADIS-A. The convergent validity of the GDT and GADIS-A were acceptable. CONCLUSIONS: The Chinese versions of the GDT and GADIS-A are valid and reliable tools that can be used to assess gaming disorder in Taiwanese young adults. Measurement invariance across genders was supported for both tools. The convergent validity of the GDT and GADIS-A were also satisfactory.

Rasch Analysis of the Stroke Impact Scale-16.

IMPORTANCE: Because the psychometric evidence supporting the use of the Stroke Impact Scale-16 (SIS-16) is limited, an examination of its psychometric properties is warranted. OBJECTIVE: To evaluate the psychometric properties of the SIS-16 using Rasch analysis. DESIGN: Secondary data analysis of responses to the SIS-16 from the published Field Administration of Stroke Therapy-Magnesium Trial database. SETTING: Emergency medical system agencies and acute care receiving hospitals. PARTICIPANTS: A total of 1,010 people with stroke. OUTCOMES AND MEASURES: We examined the item difficulty hierarchy, item fit, person-item match, separation index, person reliability coefficient, and ceiling and floor effect of the SIS-16. RESULTS: The item "climb a flight of stairs" was the most difficult, and "sit without losing balance" was the easiest. Four items misfit the Rasch partial-credit measurement model. Overall, the average patient ability estimate of 2.1 logits (SD = 2.0) was higher than the average item difficulty estimate of 0.0 logits (SD = 1.1). With a separation index of 2.85, the SIS-16 can differentiate people into 4.1 statistically distinct strata. The person reliability coefficient was .89. Given that 24.2% (n = 244) obtained the maximum score and 0.2% (n = 2) obtained the minimum score, the SIS-16 had a ceiling effect in this patient sample. CONCLUSIONS AND RELEVANCE: Results partially support the validity and clinical use of the SIS-16 in subacute stroke clinical settings. Further research is warranted to examine the psychometric properties of the SIS-16 in patients with chronic stroke. What This Article Adds: Our results partially support the use of the SIS-16 in clinical and research settings.

Dynamic changes of quality of life in muscle-invasive bladder cancer survivors.

BACKGROUND: To explore the dynamic changes and effects of radical cystectomy on quality of life in muscle-invasive bladder cancer survivors. METHODS: Patients with muscle-invasive bladder cancer were randomly recruited in this study. We used the World Health Organization Quality of Life-Brief questionnaire to assess consecutive patients' quality of life. We applied kernel smoothing to illustrate the dynamic changes of the domain and item scores after treatment. Mixed-effects models were constructed to determine the effects of radical cystectomy on the scores of each item and domain of the World Health Organization Quality of Life-Brief questionnaire after controlling demographic and clinical factors. RESULTS: We collected 397 repeated measurements of the World Health Organization Quality of Life-Brief questionnaire from 109 muscle-invasive bladder cancer patients. Forty-two of them received radical cystectomy. Patients with radical cystectomy exhibited higher levels of education, less co-morbidities (i.e., diabetes and heart diseases), but were associated with more malignancies. Construction of mixed-effects models showed patients with radical cystectomy and those with bladder sparing had similar scores in the three main domains and their items, except that of certain items of physical domain. By applying kernel smoothing method, we found that stage III-IV patients consistently showed higher scores on sleep and rest after radical cystectomy for more than 5 years. In contrast, stage II patients receiving radical cystectomy did not show a higher score on the "sleep and rest" item compared with those with bladder sparing operation. CONCLUSIONS: Radical cystectomy may result in sound sleep and rest, especially in those with stage III-IV bladder cancer.

Improving the utility of the European Health Literacy Survey Questionnaire: a computerized adaptive test for patients with stroke.

PURPOSE: Health literacy among patients is crucial for effective stroke management. The European Health Literacy Survey Questionnaire is a theory-based measure that comprehensively captures 12 domains of health literacy. We aimed to develop a computerized adaptive test of the European Health Literacy Survey Questionnaire to efficiently assess health literacy among patients with stroke. MATERIALS AND METHODS: The European Health Literacy Survey Questionnaire data of 311 patients and item parameters were retrieved from a Rasch validation study. Real data simulations were performed to develop a computerized adaptive test of the European Health Literacy Survey Questionnaire and explore its efficiency and reliability. RESULTS: The computerized adaptive test of the European Health Literacy Survey Questionnaire displayed suitable reliability in all 12 domains (0.72-0.84) with a mean test length of 17 items (36.2% of the 47-item European Health Literacy Survey Questionnaire). CONCLUSIONS: Our findings indicate that the computerized adaptive test of the European Health Literacy Survey Questionnaire, which assesses 12 domains of health literacy among patients with stroke in a timely and precise fashion, is efficient and reliable.Implications for rehabilitationThe computerized adaptive test of the European Health Literacy Survey Questionnaire assesses the subjective fit of personal health literacy competencies to environmental demands, providing insight into patient strengths and weaknesses when dealing with health tasks and interacting with health systems.The computerized adaptive test of the European Health Literacy Survey Questionnaire assesses the 12 domains of health literacy among patients with stroke in a timely and precise manner.Our study has demonstrated the utility of the computerized adaptive test of the European Health Literacy Survey Questionnaire in reducing the assessment burden of patients in clinical practice.Developing of the computerized adaptive test of the European Health Literacy Survey Questionnaire provided findings that may benefit researchers and clinicians interested in developing efficient outcome measures.

Determinants and Dynamic Changes of Generic Quality of Life in Human Bladder Cancer Patients.

We measured and determined the factors associated with long-term generic quality-of-life (QOL) changes in human bladder cancer patients. We utilized the World Health Organization QOL-Brief questionnaire to assess consecutive patients' QOL at outpatient clinics of our hospital. A mixed-effects model was constructed to investigate the determinants of QOL changes according to each domain and individual item after controlling for demographic and clinical factors, as well as the effect of radical cystectomy. We also applied a kernel smoothing method to describe the long-term dynamic changes after the first definite treatment. In total, 1185 repeated measurements were collected from 343 bladder cancer patients. The mixed-effects models demonstrated that marital status, monthly income, and comorbidity with heart disease and diabetes were significant determinants among all the study participants. Regardless of the urinary diversion type, radical cystectomy contributed to lower scores for all four domains, mainly from 4-5 years after cystectomy, which declined significantly in patients who were older than 60 years. As for non-muscle-invasive bladder cancer (NMIBC) patients with preserved bladders, tumor recurrence was a major predictor for lower scores for sexual activity in the social domain. In summary, generic QOL can be independently influenced by many factors, not only cystectomy and tumor recurrence, which should be discussed with patients before treatment.

Factors affecting Pakistani young adults' intentions to uptake COVID-19 vaccination: An extension of the theory of planned behavior.

INTRODUCTION: Aside from personal beliefs, young adults' intention to uptake the COVID-19 vaccine can be influenced by their fear of COVID-19 and perceived infectability of COVID-19. The present study incorporated fear of COVID-19 and perceived infectability with the theory of planned behavior (TPB) to form an expanded TPB to analyze factors affecting Pakistani young adults' intentions to uptake the COVID-vaccine in Pakistan. METHODS: A cross-sectional study was conducted and recruited participants from Pakistani social media users. The proposed extended TPB model was examined by using structural equation modeling. RESULTS: A total of 1034 individuals replied to the survey. The three factors of the original theory of planned behavior and the fear of COVID-19 were positively related to their intention to uptake COVID-19 vaccination (r = 0.25-0.66). Moreover, the perceived infectability positively influenced the three theories of planned behavioral factors and the fear of COVID-19 (r = 0.27-0.60), also affecting the participants' intentions to uptake COVID-19 vaccination. CONCLUSIONS: Perceived infectability was positively related to the participants' intentions to uptake COVID-19 vaccination, and perceived behavioral control was the strongest mediator. More evidence-based information concerning treatments and COVID-19 vaccination are needed to encourage individuals to uptake the vaccine.

Evaluation of the Learning Curve in Robotic Nipple-sparing Mastectomy for Breast Cancer.

BACKGROUND: This study discusses the preliminary results of robotic nipple sparing mastectomy (R-NSM) in patients with breast cancer and analyzes the learning curve of the same surgeon in a single medical center. PATIENTS AND METHOD: Patients with breast cancer from a single center who received R-NSM between 2018 to 2020 were recruited for clinical and pathologic tumor characteristics including family history, grade, type of tumor, treatment, and outcome. The learning curve for R-NSM was analyzed by using cumulative sum (CUSUM). RESULTS: A total of 85 R-NSM procedures from 78 patients were evaluated. In the CUSUM plot analysis of the learning curve, a significant decrease in time for mastectomy, reconstruction, and total operation appeared in the 22nd, 23rd, and 26th procedures, respectively. Patients' body weight, gel implant size, and specimen weight had significant correlations with the time for mastectomy. Four (5.6%) patients had nipple partial ischemia, and 1 (1.4%) had total nipple necrosis. The mean follow-up was 11.4 ± 6.2 months; only 1 patient showed recurrence. CONCLUSION: Robotic breast surgery is a feasible method with good cosmetic outcome under suitable patient selection. Oncologic safety is not a reason to stop its development.

Receptor discordance and phenotype change in metastatic breast cancer.

BACKGROUND: changes may occur in tumor phenotype and receptor status during the progression of breast cancer. Discordance between primary and metastases has implications for further treatment and prognosis. METHODS: 185 patients confirmed breast cancer metastasis were retrospectively analyzed during 1999-2019. All the pathological assessments of receptors and phenotypes of both primaries and metastases were recorded. RESULTS: rates of receptor discordance were 18.65%, 30.57%, and 16.06% for ER, PR, and HER2, respectively and 31.62% for phenotype change. Patients with ER discordance experienced a worse OS and PMS, and those with ER loss had worse PMS compared with ER positive concordance. Patients with PR discordance experienced poorer OS and loss of PR positivity also had decreased OS and PMS when comparing with PR positive concordance. There was also significantly poorer PMS of hormon receptor (HR) discordance than HR positive concordance. In phenotype change, the luminal A type concordance group showed better PMS result. CONCLUSIONS: this study demonstrated that discordance in subtype and receptor status between primary and metastatic lesions ultimately affects the survival and has a potential impact on treatment options.

Development and Validation of the Occupational Therapy Engagement Scale for Patients with Stroke.

BACKGROUND/AIM: Almost all interventions in occupational therapy require the active engagement of the patients. However, no scale has been specifically designed for assessing engagement in occupational therapy. The purposes of this study were to develop the occupational therapy engagement scale (OTES) and to examine its unidimensionality, reliability, and predictive validity. METHODS: The OTES was developed through the review of similar scales, eight experts' opinions, cognitive interviews, and pilot testing. The unidimensionality was verified with Rasch model fitting and principal component analysis. The Rasch reliability was also estimated. Pearson's correlation coefficient (r) was used to validate the predictive validity by examining the association between the Rasch scores of the OTES and patients' performance of activities of daily living (ADL). RESULTS: A total of 253 patients with stroke were rated by 22 therapists using the OTES. The mean age of the patients was 62.3 ± 13.2 years old, and 65.2% of the patients were male. The infit and outfit MNSQ of the 12 items of the OTES ranged from 0.62 to 1.34. The unexplained variance of the first dimension of the principal component analysis was 4.0%. The mean person reliability of the OTES was 0.88. Pearson's r between the OTES and patients' ADL performance was 0.37. CONCLUSIONS: The results of Rasch analysis supported that the items of the OTES were unidimensional. The OTES had sufficient person reliability and predictive validity in patients with stoke.

Rasch Analysis of the 9-Item Shared Decision Making Questionnaire in Women With Breast Cancer.

BACKGROUND: Shared decision making (SDM) is a best practice to help patients make optimal decisions by a process of healthcare, especially for women diagnosed with breast cancer and having heavy burden in long-term treatments. To promote successful SDM, it is crucial to assess the level of perceived involvement in SDM in women with breast cancer. OBJECTIVE: The aims of this study were to apply Rasch analysis to examine the construct validity and person reliability of the 9-item Shared Decision Making Questionnaire (SDM-Q-9) in women with breast cancer. METHODS: The construct validity of SDM-Q-9 was confirmed when the items fit the Rasch model's assumptions of unidimensionality: (1) infit and outfit mean square ranged from 0.6 to 1.4; (2) the unexplained variance of the first dimension of the principal component analysis was less than 20%. Person reliability was calculated. RESULTS: A total of 212 participants were recruited in this study. Item 1 did not fit the model's assumptions and was deleted. The unidimensionality of the remaining 8 items (SDM-Q-8) was supported with good item fit (infit and outfit mean square ranging from 0.6 to 1.3) and very low unexplained variance of the first dimension (5.3%) of the principal component analysis. The person reliability of the SDM-Q-8 was 0.90. CONCLUSIONS: The SDM-Q-8 was unidimensional and had good person reliability in women with breast cancer. IMPLICATIONS FOR PRACTICE: The SDM-Q-8 has shown its potential for assessing the level of perceived involvement in SDM in women with breast cancer for both research and clinical purposes.

Psychometric evaluation of the WHOQOL-BREF, Taiwan version, across five kinds of Taiwanese cancer survivors: Rasch analysis and confirmatory factor analysis.

BACKGROUND: Quality of life (QoL) is important for clinicians to evaluate how cancer survivors judge their sense of well-being, and WHOQOL-BREF may be a good tool for clinical use. However, at least three issues remain unresolved: (1) the psychometric properties of the WHOQOL-BREF for cancer patients are insufficient; (2) the scoring method used for WHOQOL-BREF needs to be clarify; (3) whether different types of cancer patients interpret the WHOQOL-BREF similarly. METHODS: We recruited 1000 outpatients with head/neck cancer, 1000 with colorectal cancer, 965 with liver cancer, 1438 with lung cancer and 1299 with gynecologic cancers in a medical center. Data analyses included Rasch models, confirmatory factor analysis (CFA), and Pearson correlations. RESULTS: The mean WHOQOL-BREF domain scores were between 13.34 and 14.77 among all participants. CFA supported construct validity; Rasch models revealed that almost all items were embedded in their expected domains and were interpreted similarly across five types of cancer patients; all correlation coefficients between Rasch scores and original domain scores were above 0.9. CONCLUSION: The linear relationship between Rasch scores and domain scores suggested that the current calculations for domain scores were applicable and without serious bias. Clinical practitioners may regularly collect and record the WHOQOL-BREF domain scores into electronic health records.

Dynamic Changes Of Body Image And Quality Of Life In Breast Cancer Patients.

PURPOSE: Dynamic changes of body image and quality of life (QoL) in breast cancer patients were not commonly investigated. We aimed to compare the dynamic changes in QoL and body image of breast cancer survivors receiving breast-conserving surgery or total mastectomy within 5-10 years after surgery. METHODS: Patients with non-metastatic breast cancer who received surgery were invited to complete the World Health Organization Quality of Life-Brief (WHOQOL-BREF) questionnaire and the Body Image Scale (BIS) within 10 years after surgery. We applied kernel smoothing methods to capture the dynamic changes of the patients' QoL and body image within 5 years after surgery. We also constructed multiple linear regression models to identify predictive factors for QoL and body image. RESULTS: A total of 581 patients were collected, and 211 of them received breast-conserving surgery. There were no statistically significant differences in QoL and body image for breast-conserving surgery versus total mastectomy, but the former showed fluctuating trends. BIS was a predictor of every item and domain in the WHOQOL-BREF in the multiple linear regression model, and explanatory of the trends of dynamic change over time. Patients without lymph node dissection seemed to have less positive feelings but were more satisfied with sexual activities. CONCLUSION: Body image is predictive of the QoL of breast cancer patients. Dynamic changes of body image and QoL would be useful for shared decision-making regarding surgery in breast cancer patients.

Lifetime risks, loss of life expectancy, and health care expenditures for 19 types of cancer in Taiwan.

BACKGROUND: The mortality rates for different cancers are no longer an efficient tool for making national policy. The purpose of this study were to quantify the lifetime risks, life expectancies (LEs) after diagnosis, expected years of life lost (EYLL), and lifetime health care expenditures for 19 major cancers in Taiwan. METHODS: A total of 831,314 patients with 19 pathologically proven cancers were abstracted from the Taiwan Cancer Registry from 1998 to 2012. They were linked to the National Mortality Registry (1998-2014) and National Health Insurance reimbursement database (1998-2013) for survival and health care costs. We estimated the cumulative incidence rate for ages 0-79 years and the lifetime survival function for patients with different cancer sites. The EYLL was calculated by subtracting the LE of each cancer cohort from that of the age- and sex-matched referents simulated from national life tables. The estimated lifetime cost was calculated by adding up the product of survival probability and mean cost at the corresponding duration-to-date after adjustment for the inflation to the year of 2013. RESULTS: There were 5 cancers with a lifetime risk exceeding 4%: colorectal, liver, lung, and prostate in males, and breast and colorectal in females. Cancers with EYLL of >10 years were: esophageal, intrahepatic bile ducts, liver, pancreas, oral, nasopharyngeal, leukemia, lung, and gallbladder, extrahepatic bile ducts and biliary tract in males, and intrahepatic bile ducts, pancreas, nasopharyngeal, lung, esophageal, leukemia, liver, gallbladder, extrahepatic bile ducts and biliary tract, ovary, and stomach in females. Cancers with lifetime health care expenditures exceeding US$50,000 to the National Health Insurance were as follows: leukemia, kidney, testis, renal pelvis and ureter in males, and renal pelvis and ureter, leukemia, breast, urinary bladder, kidney, ovary, and nasopharyngeal in females. All these impacts should be considered in health policy decisions. CONCLUSION: The impacts of cancer in Taiwan are very large. Future studies must consider both quality of life and the entire impact from societal perspectives.

Evaluating the European Health Literacy Survey Questionnaire in Patients with Stroke: A Latent Trait Analysis Using Rasch Modeling.

BACKGROUND: The effective self-management and treatment of long-term disability after stroke depends greatly on the health literacy of patients. The European Health Literacy Survey Questionnaire (HLS-EU-Q) is a comprehensive and theory-based measure that captures multiple self-perceived competencies of health literacy and covers a diverse range of health contexts. However, there is no psychometric evidence on the HLS-EU-Q in the stroke population. OBJECTIVE: The aim of this study was to examine the validity of the HLS-EU-Q in patients with stroke using Rasch analysis. METHODS: We compared the model deviance among the one-domain, three-domain, four-domain, and 12-domain structures using likelihood ratio tests to determine the dimensionality of the HLS-EU-Q. Thereafter, we examined the unidimensionality of each domain, local independence, item fit, response categories, and differential item functioning (DIF) for the best fitting structure. RESULTS: A total of 311 patients with stroke participated in this study. Rasch analysis revealed that the 12-domain HLS-EU-Q demonstrated the best data-model fit. The original 4-point scales showed disordering, which can be corrected by rescaling them as 3-point scales with the two middle categories collapsed. All 47 items in the rescaled HLS-EU-Q fit the 12-domain Rasch model, demonstrated local independence, assessed the 12 unidimensional domains respectively, and had invariant difficulties between different age or education groups of the patients with stroke. CONCLUSION: We recommend using the 12-domain scores of the rescaled HLS-EU-Q to comprehensively and accurately capture the competencies to access, understand, appraise, and apply health information within the three health contexts of healthcare, disease prevention, and health promotion for patients with stroke.

Psychometric validation of the Persian nine-item Internet Gaming Disorder Scale - Short Form: Does gender and hours spent online gaming affect the interpretations of item descriptions?

Background and aims The nine-item Internet Gaming Disorder Scale - Short Form (IGDS-SF9) is brief and effective to evaluate Internet Gaming Disorder (IGD) severity. Although its scores show promising psychometric properties, less is known about whether different groups of gamers interpret the items similarly. This study aimed to verify the construct validity of the Persian IGDS-SF9 and examine the scores in relation to gender and hours spent online gaming among 2,363 Iranian adolescents. Methods Confirmatory factor analysis (CFA) and Rasch analysis were used to examine the construct validity of the IGDS-SF9. The effects of gender and time spent online gaming per week were investigated by multigroup CFA and Rasch differential item functioning (DIF). Results The unidimensionality of the IGDS-SF9 was supported in both CFA and Rasch. However, Item 4 (fail to control or cease gaming activities) displayed DIF (DIF contrast = 0.55) slightly over the recommended cutoff in Rasch but was invariant in multigroup CFA across gender. Items 4 (DIF contrast = -0.67) and 9 (jeopardize or lose an important thing because of gaming activity; DIF contrast = 0.61) displayed DIF in Rasch and were non-invariant in multigroup CFA across time spent online gaming. Conclusions Given the Persian IGDS-SF9 was unidimensional, it is concluded that the instrument can be used to assess IGD severity. However, users of the instrument are cautioned concerning the comparisons of the sum scores of the IGDS-SF9 across gender and across adolescents spending different amounts of time online gaming.

A Systematic Review of Tests Assessing Stroke Knowledge.

BACKGROUND: Accurate assessment of stroke knowledge (SK) is fundamental to the successful understanding of, monitoring of, and intervening to improve the SK of patients and the public. PURPOSE: The purpose of this study is to perform a systematic review of the existing SK tests and appraise their conceptual basis, feasibility, and psychometric properties. We conducted 2-step searching of MEDLINE, CINAHL, PsycINFO, and Scopus electronic databases from January 1, 2000, to December 31, 2014, to identify relevant SK tests for the appraisal. RESULTS: Our study found 59 SK tests, out of a total of 93 articles, with full content available that had been referred to in the published literature. Ten of them had been used in more than 1 study, and 2 (the Stroke Knowledge Test and the Stroke Action Test) of them have had at least 1 of their psychometric properties validated. Only 1 test (the Stroke Knowledge Test) was developed using rigorous methodology, covers a wide range of concepts, and met all feasibility criteria; however, its limitations include no articulated conceptual basis, inadequate internal consistency reliability (α = .65), and lack of some validated psychometric properties. CONCLUSIONS: Our study revealed that current available tools are not sufficiently able to accurately and reliably assess SK to promote stroke prevention and management. CLINICAL IMPLICATIONS: This study highlights the attention of applying current SK tests and need for revising existing tests or developing a new test.

Rasch Analysis of the General Self-Efficacy Scale in Workers with Traumatic Limb Injuries.

Purpose The purpose of this study was to apply Rasch analysis to examine the unidimensionality and reliability of the General Self-Efficacy Scale (GSE) in workers with traumatic limb injuries. Furthermore, if the items of the GSE fitted the Rasch model's assumptions, we transformed the raw sum ordinal scores of the GSE into Rasch interval scores. Methods A total of 1076 participants completed the GSE at 1 month post injury. Rasch analysis was used to examine the unidimensionality and person reliability of the GSE. The unidimensionality of the GSE was verified by determining whether the items fit the Rasch model's assumptions: (1) item fit indices: infit and outfit mean square (MNSQ) ranged from 0.6 to 1.4; and (2) the eigenvalue of the first factor extracted from principal component analysis (PCA) for residuals was <2. Person reliability was calculated. Results The unidimensionality of the 10-item GSE was supported in terms of good item fit statistics (infit and outfit MNSQ ranging from 0.92 to 1.32) and acceptable eigenvalues (1.6) of the first factor of the PCA, with person reliability = 0.89. Consequently, the raw sum scores of the GSE were transformed into Rasch scores. Conclusions The results indicated that the items of GSE are unidimensional and have acceptable person reliability in workers with traumatic limb injuries. Additionally, the raw sum scores of the GSE can be transformed into Rasch interval scores for prospective users to quantify workers' levels of self-efficacy and to conduct further statistical analyses.

A Facile PDMS-Assisted Crystallization for the Crystal-Engineering of C60 Single-Crystal Organic Field-Effect Transistors.

Poly(dimethylsiloxane) (PDMS)-assisted crystallization (PAC) is a facile method to produce oriented C60 crystal arrays. Changing the drying mechanism from evaporation to solvent absorption (by PDMS) widens the solvent selection and facilitates the engineering of both the macroscopic shape and the microscopic lattice structure of the crystal arrays. The method also shows the potential to be applied to other organic semiconductors and large-area production.